Double bellows controlled respiration unit



Feb. 9, 1960 M. H. GOODNER DOUBLE BELLOWS CONTROLLED RESPIRATION UNITFiled Jan. 22, 1958 ATTO N EY United States Patent 2,924,215 DOUBLEBELLOWS CQJDlLI'IiROLLED RESPIRATION Monroe H. Goodner, Red Bank, N.J.,assignor to Stephenson Corporation, Red Bank, N .J., a corporation ofNew Jersey Application January 22, 1958, Serial No. 710,501

5 Claims. (Cl. 128-29) This invention relates to a Controlled breathingdevice and is a modification of the device disclosed in my copendingapplication Serial No. 633,163, filed lanuary 8, i957.

The device disclosed in said co-pending application comprises a singlemain bellows communicating through valve means directly with a patientor indirectly, as through anesthesia equipment, and alternatelycollapsed and expanded to supply gas or gases under controlled pressureinto a patients lungs and to exhaust gas from a patients lungs undercontrolled negative pressure. A storage chamber is provided in the formof a smaller bellows communicating with the main bellows through two separate, weighted valves through which gas may be removed from the mainbellows to the storage bellows if the pressure in the main bellowsexceeds a predetermined maximum, and through which gas may be returnedto the main bellows from the storage bellows if the pressure in the mainbellows falls below a predetermined minimum. Since the said storagebellows and weighted valves form no part of this invention, they are notdescribed herein and are shown in the drawing only to illustrate thatthe device of the said co-pending application may be incorporated as aunit in the apparatus disclosed herein.

The'device which is the subject of this application can be used whereverthe device of said co-pending application is used, and, in addition, isparticularly applicable in the case of patients, such as someconvalescent patients,

for example those convalescing from polio, where the device must be keptin'use to control breathing for periods of several hours. In such casesit is especially desirable to avoid the possibility of contamination ofthe gases supplied to the patient due to passing through container,storage, or conduit means through which pass the gases Withdrawn fromthe patients lungs.

It is accordingly an object of this invention to provide a controlledbreathing device for controlling the volume of gas supplied to andremoved from a patients lungs per unit of time characterized byseparation of the path of gas supplied to the patient from the path ofgas exhausted from the patient.

Another object of this invention is to provide a device of the abovementioned kind in which a controlled breathing unit such as is disclosedin my said co -pending application may be included as part of thedevice.

The invention will best be understood if the following description isread in connection with the drawings in which i Figure 1 is a schematicview of a device embodying my invention. The numeral 10a indicates afirst collapsible gas container illustrated herein or a bellows,interconnected as by rods 13 with a second main collapsible gascontainer, illustrated herein as bellows 10b, thus pro- .viding forsimultaneous collapsing and expanding movements of said members wheneither 10a or 10b is collapsed or expanded, and p Figure 2 is a detailview in vertical section showing 2,924,215 Patented Feb. 9, 1960 theconnection and relation between conduits 75, a and 78.

Gas is supplied to a patient through the first main bellows 10a andconduit 12a, and is exhausted from the patient through conduit 12b andsecond main bellows 10b. Behows 19a has the gas intake port 54 to whicha source of gas supply may be coupled and in which the one-way checkvalve 56 is provided, and bellows 1012 has the exhaust port 76 in whichthe one-way check valve 77 is provided. The upper end of bellows 10b isconnected to the lower surface of valve chest 30 as by the ring bracket20. The lower end of bellows 10b is connected,

as by ring 17, to the base plate 14b which is connected to the lowerends of rods 13.

Bellows 10a is attached at the bottom, as by ring 15,,v

to the base plate 14a which is fixed to the rods 13 by the couplingmeans 16. Bellows 10a is attached at the bellows 10a and havetelescopically disposed within them the pistons 28 which are connectedat their closed upper ends to the upper ends of the rods 13,respectively, by the brackets 25. It will be understood that the valvechest 30 is provided with bores 32. and the cross member 22 is providedwith the bores 24 to permit the rods 13 to reciprocate freely throughthem; that rods 13 rise and fall with the pistons 27, and that as therods 13 move up and down the bellows 10a and 10b are simultaneouslycollapsed and expanded.

In the upper portion of the upper bellows 10a, a valve chamber 34 isprovided and in the upper end ofbellows 10b 2. similarvalve chamber 36is provided. As shown, these valve chambers are circular. Chamber 34 isdefined by a top plate 35 depending from cross support 22 and as shownit fits within and is supported by the annular bracket member 18. In thetop plate 35 is the port 38 anddepending from plate 35 and surroundingport 38 is the cup-shaped member 40 which defines the bottom and sidewalls of chamber 34. Stretched'horizontally across chamber 34 andsupported at its periphery by the attachment means 42 is a flexiblediaphragm 44 which carries the valve member 46 which is urged by thespring 48 in a direction away from the port 38 to leave the said portopen. In the sidewall of chamber 34, above the diaphragm 44, theapertures 50 are provided to pass into the upper portion of chamber 34gas which is re ceived into bellows loathrough the conduit 52, the inletend 54 of which may be coupled directly to a source of gas supply such,for example, as a tank of oxygen under pressure and has in it a one-waycheck valve 56 of.

known kind.

Leading from the space 39 above port 38, between the top plate 35 ofchamber 34 and the cross support member 22, is the nipple or coupling37a to which is connected the conduit 12a leading to the patient or thepatients face mask (not shown) through the branch conduit 58 which, inthe drawing, is shown broken away. When the position of diaphragm 44causes valve 46 to be open gas fl'ows from bellows 10a throughapertures50 into the upperpart of chamber 34 and through port 38 andspace 39 to conduit 12a.

Chamber 36 inbellows 10b is similar to chamber 34 and Conduit 12bcommunicates between the patient or the patients face mask and the space74 between the bottom of the valve chest 30 and plate 60. In the sidewall of ha e 6 e pert res q er v t pass x? halation' gases from thespace 74 'into bellows 1012 when 79, which; communicates 'with conduit78 1 throughbranch conduit 80, ,and fed back into saidsystemtwheneverpressure therein falls below. predetermined" amount Ill@011; duit 78 is thetwo-wayvalve '82 which, in pnegpositi'on assass npermits flow of gas in conduit '78, to inlet port 54, and; tothebag 79,and in anothert'position dischargesithe jgasto atmosphere. x

Compressed air is supplied to,;and exhaustedfrom, each of the valvechambers 34 and 36 through thegcbnduit8l aswill be explained. Duringtheexpanding movement. of

bellows 10a and -10bthis pressure is suppliedftdthevalve chambers andserves to counter-balance the springsw48 and 70, respectively,' andtherefore to hold valvetmembers 46 closed and valve member 68openvduring the expansion. of said bellows thus preventing'supply of gas tothe pa- 'tients lungsand causing gas to be .withdtafvtnQfrom ,the

patients lungs. Upon the upward, collapsingmovement of the bellows10aand 10b the pressureis released'from under the valve diaphragms throughconduit 81, permitting them tomove downward, and spring 48 then servesto hold valve 68 open and spring 70 serves to hold valve 68 closed, thuscausing gas to be supplied totthe patient from bellows 10a. and causinggasp previously exhaustedfrom the patient tobe dischargedfrom bellows10b.

' Except for, the addition of compressed air conduiti 81/81a, thestructure of valvechest and thesmeans provided;forcollapsing andexpanding the bellows 10a and 10b; and ft'or regulating the durationofeach of'these movements, and for providing a dwellfi orflattening of tthe inhalation'or exhalation curve near its end (flattening of thetexhalation curve being illustratedhereinl ma'y be. thesame as thoseillustrated and fully describedtinmy co pendinglapplication Serial No.633,163 These means in: clude the three needle valves 82, 84'and86'gwhich are controlledrespectively by knobs 83), 85 and 87 each ofwhich is surrounded bya calibrated ring. These valves control the flowof compressed air within passages schematically illustratedin Figure l.The compressed air or equivalent means used in'thesaid passages isemployed for collapsing containers 1041 and 10b simultaneously and isentirely separate from the gas or gases contained within thecontainermeans and exchanged between said means and the 4 patient directly, orindirectly as through anesthesiajequip ment.

Valve-82. controls the admission of compressed air from supply couduit88 to passage 9 0 from which it flows to passage'92' when valve member94'of valve assembly-v is unseated. Passage 92 communicates with bothhollow mns 2 h u h b a h s aend. b .ands sup-l plied and x u t d th qusPa a 92' erv o raise d lowerithe cylindrical pistons28'which'move up anddown within said columns and in turn raise and lower the' base plates orplatform members 14aand 14b-thereby collapsingeorr expanding thebellows- 10a and-10b;

a v is unseated and valvemember 94 is seated, which is the positionshown in Figure 1. Conduit 81 through branch 81a communicates withpassage 96 between valve assembly v and valve member 84, andconsequently supplies compressed air to chambers 34 and 36, under thediaphragms .44 and 64, respectively, during the time valve ring 98 isunseated and the compressed air is flowing out of columns- 26 :andl thebellows slfial and 10B are conse quently expanding, causingvalve 46 tocloseand valve 68 to open Tho-pressure under the diaphragms 44v and t 64is released when valve ring 98 istclosed du'ringfwhich time conduit 81is able to exhaust gas throughpassages 81a, 96' and 97, thuscausingvalve 46 to open and valve 68 to close: At this time compressedairsupplied through passage 90, past valve 'hfifid94 andgthrough passage92, is raising the pistons 28, thus collapsing the bellows 10a and 10band gas is being supplied to the patient while exhalationg gases;areztbeing separately exhausted from bellows 10hr: V i t r i Valve 86controls thewexhaustingaof,fairs from an air chamber100 in valve chest30'through passage 102 The outer end portions of passages; 96 and 102.are shown merging infa common dischargepassage 104.

Air chamben100uis ,notsupplied with compressed air but, isgconnectedtomatmosphere through passage 102. Piston-r108 is vurged. in a directionaway from the outlet. to passage; 102 by coil.spring,109;andt has theplunger 110 extending through the; top oftthe chamber in which n thesmall port 106 is provided. Whenthe descending base plate orplatform14astrikes plunger 110 its downwards movement is resisted and slowedinproportion to the rate atwhich the. adjustmentof valve86allows air toescape 1 V fromtchamberillw throughpassagedlflz" Valve 86 may beadjusted tol slow thedownward movement; of piston 108 so thatdnringthefinal portion of the expansion of bellows 10aLand-10b thenegative pressure exerted 'on the patients lungs from container.10/bellows 10b, as for example through anesthesia equipment and'a facemask, issubstantially level thus providing in effect a pause between theexhalation and inhalation phases of a breathing cycle.

As is explained in my co-pendirigapplication, this levelling Qfi, offthe pressure curve approaching zero' provides a pause.in the breathingcycle enabling the operator to make the cycle of the devicecorrespondrwithtthe breathing cycle of the patient; The, duration of theinterval dur-' ing which thejpressure curveis thus substantiallyflattened is determinedtbyfthe} position 10f, baseplate 14a when itstrike'splunger llot and} in thef illustrated embodiment of rtheQinVention this {depends ,upon the distance, to which valdurin'glwhich the pressure remains substantially constant can beobtainedsubstantiallybetween the inhalation and exhalation phases. 1 t

Theposition of valve assembly v is controlled by toggle mechanismscomprising the toggle arms 112 and 113, the

knifeedge inner ends of which are received in the V-shaped 1indentations a. and b providedin the opposite faces of the Valve84controls theexhausting of airfrom columns t 26 Land passage, 92 and92arand 91b through 5 passage 96 ,t when the ring 98 on the head portion92 0f; yal vezaSSfim W enlarged lower end.114a ofthe control rod 114extending upwa dlyjromfthe top of valve chest 30. Rod 114? is supportedby said toggle'arms and is movableup and down to actuate the togglemechanism, being guided by the downwardly extending guide pin 115 whichextends'into a guiding-vertical-borei provided in the valve chest 30.1

Toggle arm- 112 is "supported, at its outer end on the re du'ced-portienIIS of a post 116*pi'ojecting up t'rom valve' arm 113is=connected tothereduced portion 119 of valve stem 120 of the valve assembly v. p Theouter'ends .of the t ss azarsareicinedztenement-by"coilrspringimeansnzz.

Projectingfrom the moving base plate 14a is a lip 124, shownschematically in Figure 1 asanangle extension member, having a slot 126through which the control rod 114 extends. On rod 114 below the outerend of extension 124 is a lower fixed stop '128', and above the outerend of extension 124 is an upper adjustable stop 130, rod 114 beingpreferably calibrated to facilitate setting of the positionofadjustabl'estop 130 as may be desired to determine the volume ofbellows a and 10b, i.e., the extent to .which they can be expanded whichof course determines the volume of gas 10b can receive from the patientslungs, and the volume of gas 10a can transfer to the patients lungs whenit is collapsed. 1

When expansion of bellows 10a moves its lower end to the end of itsdownward stroke lip 124 contacts fixed stop 128 and moves control rod114 downwardly enough to actuate said toggle arms downwardly, thusraising valve stem 120 and ending the negative or exhalation phase ofthe breathing cycle and starting the succeeding positive phase. When thecollapsing of container 10a causes the lip 124 to strike the upperadjustable stop member 130 control arm 114 is elevated just enough totrip the toggle mechanism and lower valve stem 120 causing valve 94 toclose and unseating ring 98, thus ending the positive phase of thebreathing cycle and starting the negative phase.

Control rod 114 may be raised or lowered and locked in either of saidpositions to stop automatic operation of the device, by means of acontrol dial 132 on the upper end of control rod 114. Since the meansfor raising and lowering the control rod forms no part of this inventionand is fully described in my said co-pending application, it is notdescribed here except to say that the dial 132' may be turned from amiddle running position in one direction for locking it in raisedposition and in the other direction for locking it in lowered position.When the dial 132 is in raised position, the valve assembly v is loweredand valve 98 in passage 92 is open so that when the dial is turned tothe middle position auto matic operation will be resumed at the start ofthe downward movement of the containers 10a and 10b which correspondswith the exhalation phase of the breathing cycle.

When the dial is in lowered position, the valve assembly v is raised andvalve 98 is closed, and valve 94 in passage 92 is open so that when thedial is turned to middle or running position automatic operation will beresumed at the start of the upward movement of the containers 10a and10b which corresponds with the inhalation phase of the breathing cycle.The dial 132 is shown provided with the finger piece 132a.

The structure shown herein above cross member 22 between intake conduit52 and the nipple 56 forms no part of this invention and is illustratedherein merely to indicate that the complete device as disclosed in myco-pending application may be bodily incorporated in a device of thekind disclosed herein.

There has thus been provided a device in which the objects stated abovehave been achieved in a practical way.

What I claim is:

1. Apparatus for controlling breathing comprising two expansible andcollapsible gas containers and means in- .tercorinecting the containersfor operation in unison, an inlet port in one of said containers forconnection to a source of gas supply, conduit means for providingcommunication between said container and a patient, conduit means forproviding communication between the patient :and the other container,exhaust port means for exhausting gas from said other container, meansfor alternately expanding and collapsing said containers simultaneously,valve means, for closing the conduit between said one container and thepatient while said containers are expanding and gas is consequentlybeing drawn into said one container from isaid source and gas is beingdrawninto the other container from the patients lungsrodsforalternately'collapsing and expanding said gas containers.

2. Apparatus for controlling breathing comprising two expansible andcollapsible gas containers and means interconnecting the containers foroperation in unison, an inlet port in one of said containers forconnection to a source of gas supply, conduit means for providingcommunication between said container and a patient, conduit means forproviding communication between the patient and the other container,exhaust port means for exhausting gas from said other container, meansfor alternately expanding and collapsing said containers simultaneously,valve means, for closing the conduit between said one container and thepatient while said containers are expanding and gas is consequentlybeing drawn into said one container from said source and gas is beingdrawn into the other container from the patients lungs and for openingthe conduit between said one container and the patient while saidcontainers are collapsing and gas is consequently being supplied to thepatient from said one container and gas is being exhausted from saidsecond container through said exhaust port means, other valve means forcontrolling flow of gas from the patient into said other container,pressure responsive means tending to hold the first-mentioned valvemeans closed and the second mentioned valve means open, and means foralternately exerting pressure and relieving pressure to control theoperation of said valve means.

3. Apparatus for controlling breathing comprising two expansible andcollapsible gas containers and means interconnecting the containers foroperation in unison, an inlet port in one of said containers forconnection to a source of gas supply, conduit means for providingcommunication between said container and a patient, conduit means forproviding communication between the patient and the other container,exhaust port means for I exhausting gas from said other container, meansfor alternately expanding and collapsing said containers simultaneously,valve means, for closing the conduit between said one container and thepatient while said containers are expanding and gas is consequentlybeing drawn into said one container from said source and gas is beingdrawn into the other container from the patients lungs and for openingthe conduit between said one container and the patient while saidcontainers are collapsing and gas is consequently being supplied to thepatient from said one container and gas is being exhausted from saidsecond container through said exhaust port means, and means forconnecting said inlet and outlet ports to provide a closed circuit.

4. The apparatus claimed in claim 3 including a 2-way valve means in theconnecting means for controlling the proportion of exhaled gasrecirculated to said inlet and the proportion discharged to atmosphere.

5. Apparatus for controlling breathing comprising two expansible andcollapsible gas containers and means in I terconnecting the containersfor operation in unison, an inlet port in one of said containers forconnection to a source of gas supply, conduit means for providingcommunication between said container and a'patient, conduit means forproviding communication between the patient and the other container,exhaust port means for exhausting gas from said other container, meansfor alternately expanding and collapsing said containers simultaneously,valve means, for closing the conduit between for connecting saidinletand outlet ports to provide; a

closed I circuity a "gas storage member; means communi eating betweensaid storage; member. 'andasaid xzdnncting

